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General NPI Number Information
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NPI Number | 1639003809
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Entity Type | Individual
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Provider Name | MICHAELA HENNEBERRY DNP, ARNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 1005 BLAIRS FERRY RD NE STE 30
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-1292
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Country | US
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Telephone | 319-289-7779
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Fax | 319-320-4644
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Provider Business Mailing Address
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Address Line | 6800 LAKE DR STE 285
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City | WEST DES MOINES
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State | IA
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Zip | 50266-2544
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Country | US
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Telephone | 515-226-3116
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Fax | 515-223-9341
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A189940
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License Number State | IA
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